Graphic Warnings Ineffective On Young Smokers
September 5, 2013

Graphic Warnings Ineffective On Young Smokers

Brett Smith for - Your Universe Online

According to a new UK-based youth study, graphic images on cigarette packaging do not deter young smokers from lighting up. However, young people who said they had never smoked or only experimented with cigarettes reported being more affected by the cautionary graphic images depicting diseased lungs or heart surgery.

The study, which was published in the journal Tobacco Control, considered data from two youth surveys: one taken in 2008 before the British government mandated the use of cautionary graphic images on cigarette packaging and one after in 2011.

The surveys included 2,800 youths between the ages of 11 and 16 years old who were asked about the visibility and impact of text and pictorial warnings; how well the warnings acted as visual cues; how easy they were to understand; how believable they were; and how persuasive they were.

An overwhelming majority respondents in both surveys, 68 to 75 percent, said they had never smoked, 17 to 22 percent admitted to experimenting with cigarettes, and approximately 10 percent said were already smoking at least one cigarette every week.

The percentage of children who said the warnings were effective increased after the introduction of graphic imagery among non-smokers and experimental smokers. The number of so-called regular smokers who said the warnings were effective only marginally increased slightly from 13 to 14 percent.

Survey participants were also asked if they could recall either a text warning on the pack front or graphic warning on the back and say which warnings were more effective. The text warning "Smoking kills" was recalled by 58 percent in 2008, but fell to 47 percent in 2011. Meanwhile, "Smoking seriously harms you and others around you" was recalled by 41 percent in 2008 and 25 percent in 2011.

As for the images on the back of packs – which show diseased lungs, rotten teeth and neck cancer – the respondents' recall increased over the two waves of surveys, with the image of lung disease reaching a maximum of 33 percent. Recall for other back of pack images remained below 10 percent.

"As warnings need to be salient to be effective, positioning pictorial warnings only on the less visible reverse panel limits their impact," the study said. "While recall was high at both waves for pack-front warnings, it was low (below 10 percent) for the pictorial warnings on the pack reverse, fear-appeal pictures aside.”

The researchers also speculated that children may be becoming desensitized to the graphic imagery, particularly those children who admitted to being regular smokers.

"Positioning pictorial warnings only on the back of packs may have had a deterrent effect on never and experimental smokers, but for most measures no significant differences were observed,” the authors wrote. “The impact on regular smokers was negligible.”

In the US, officials are expressing concern over the rise of electronic cigarettes. Designed to replicate the conventional smoking experience, e-cigarettes heat up a nicotine cartridge up and release a nicotine vapor that can be inhaled.

"E-cigarette use is growing rapidly," Dr. Thomas Frieden, director of the CDC, said in a statement. "There is still a lot we don't know about these products, including whether they will decrease or increase use of traditional cigarettes."

The FDA has been releasing statements over the past months regarding the placement of stricter regulations on the devices.